The University of Pittsburgh Cancer Institute recently held a symposium on a breast cancer that doesn’t produce lumps or show up in mammograms. University researchers have launched a clinical trial on the cancer, known as invasive lobular carcinoma, to test hormonal therapies on women newly diagnosed with the cancer. An institute news release said the cancer is the second-most common type of breast cancer and the eighth-most common cancer in women, affecting nearly 30,000 each year. We asked Dr. Rachel Jankowitz, an assistant professor of medicine in the university’s division of hematology and oncology, to tell us more.
Why has invasive lobular carcinoma received so much less attention than the more-common invasive ductal cancers?
Historically, invasive lobular carcinoma was believed to behave similarly to invasive ductal cancer and was treated in the same way. Over the years, we have come to appreciate that patients with ILC have unique clinical and tumor characteristics. ILC tumor cells often “creep” through the tissue in a single-file pattern rather than forming a mass, so they can be difficult to detect with mammography or in physical exams. ILC tumors can also have unique patterns of metastatic spread, such as spread to the ovaries and gastrointestinal tract. We recently completed the first-ever international symposium on lobular breast cancer, and we have opened the first-ever prospective clinical trial for patients with ILC at the University of Pittsburgh Cancer Institute. Although ILC represents only about 10 percent of all breast cancers, over 30,000 patients are diagnosed with it annually, making it more common than melanoma if we ranked cancers in women.
Is there any way to screen for ILC?
In the early stages of ILC, there are often no outward signs or symptoms, such as a breast lump. That makes it difficult to diagnose with typical methods such as a physical exam or mammography. With ILC, there is more of a change in the breast tissue such as a thickening of the tissue or fullness in one part of the breast. This is just one topic we are discussing at this symposium where we have prestigious researchers from around the world here along with ILC patients to better explore this disease. This has to be a collaborative effort, as no single institution is going to see enough ILC patients to make significant progress toward better diagnosis and treatment. Our efforts at the symposium are to share ideas, research findings and clinical experience so that we can translate pre-clinical findings from the laboratory into better and more tailored patient care in a truly “bench to bedside approach.”